Late results of the Royal Free Hospital prospective controlled trial of prednisolone therapy in hepatitis B surface antigen negative chronic active hepatitis.

Kirk, A P; Jain, Shubham; Pocock, Stuart; Thomas, Howard; Sherlock, Sheila

doi:10.1136/gut.21.1.78

Cited by 257 publications

(125 citation statements)

References 19 publications

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“…One major reason may he that each o f these dis-eases has until recendy been associated with a relatively s hort median su rvival rime (autoimmune CAH 3.3 years (27 ); PSC 6 years [28]). Thus the likelihood of a second disease appearing during rhe relatively brief cou rse o f the primary one was q uite remo te.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Chronic Active Hepatitis (Lupoid Hepatitis) and Primary Sclerosing Cholangitis in Two Young Adult Females

Minuk

Sutherland

Pappas

et al. 1988

Canadian Journal of Gastroenterology

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Autoimmune chron ic active hepatitis (CAH) and primary sderosing cholangitis (PSC) arc chronic diseases of the hepatobiliary system that have many cli nica l, immunologic and genetic features in commo n. Despite these similarities, there are few reports of the two diseases coexisting. Two young women with clinical, biochemical, serologic, radiologic and histologic findings compatible with both autoimmune CAH and PSC are described. The observation that there may be a striking overlap in the featu res of these two diseases and recent improvements in diagnostic imaging of the biliary tract suggest that the association of these two diseases in the same individual may be more common than is presently appreciated. Can J Gastroentero l 1988; 2(1): 22-27

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Section: Discussionmentioning

confidence: 99%

Autoimmune Chronic Active Hepatitis (Lupoid Hepatitis) and Primary Sclerosing Cholangitis in Two Young Adult Females

Minuk

Sutherland

Pappas

et al. 1988

Canadian Journal of Gastroenterology

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“…8,18 In those who progress rapidly to fulminant (or subacute) liver failure, assessment for liver transplantation should be considered. In general, however, a greater than 2-fold elevation of aminotransferases in conjunction with interface hepatitis on liver biopsy is an indication for treatment.…”

Section: When To Treatmentioning

confidence: 99%

Current and novel immunosuppressive therapy for autoimmune hepatitis

Heneghan

McFarlane²

2002

Hepatology

190

114

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“…Therapeutic inhibition can be achieved using monoclonal antibodies or with a recombinant receptor fusion protein Anaphylaxis GI, gastrointestinal; IL-2, interleukin 2; MAPK, mitogen-activated protein kinase; mTOR, mammalian target of rapamycin; NFAT, nuclear factor of activated T cells; NFκB, nuclear factor κB; TNF, tumor necrosis factor. Kirk et al 1980;Soloway et al 1972]. Initial conflicting results regarding azathioprine [Mackay, 1968;Murray-Lyon et al 1973] were resolved with data demonstrating clear efficacy and a lower side-effect profile compared with corticosteroid monotherapy when azathioprine is used to reduce or replace corticosteroids [Summerskill et al 1975].…”

Section: Treatment Of Autoimmune Hepatitismentioning

confidence: 99%

Management of patients with difficult autoimmune hepatitis

Parker

Adams

2012

Therap Adv Gastroenterol

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Autoimmune hepatitis (AIH) is characterized by a T-cell rich infiltrate associated with lobular and interface hepatitis, hypergammaglobulinemia and production of autoantibodies. Genetic risk is linked to the HLA particularly DRB1*0301 and DRB1*0401 alleles in North American and European Caucasian populations. It has recently been suggested that functional deficiencies in CD4 + CD25 + CD127 low FOXP3 + regulatory T cells contribute to the breakdown of immune tolerance that results in AIH. Most patients respond to immunosuppressive therapy with corticosteroids and can be maintained in remission by low-dose corticosteroid treatment and/or azathioprine. For those who progress to end-stage disease liver transplantation is an effective treatment although it is associated with recurrence. In the future it is likely that biological therapies will allow more targeted therapy designed to switch the balance to immune regulation and thereby restore immune homeostasis. Although treatment for many cases is relatively straightforward and successful problems are encountered in those who fail to respond to standard treatment, are unable to tolerate it or relapse. In such cases alternative therapies should be considered. In addition treatment is complicated in some patients by comorbidity and special care is required during and after pregnancy. We will discuss the current and future therapeutic options for patients with difficult to treat AIH.

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Late results of the Royal Free Hospital prospective controlled trial of prednisolone therapy in hepatitis B surface antigen negative chronic active hepatitis.

Cited by 257 publications

References 19 publications

Autoimmune Chronic Active Hepatitis (Lupoid Hepatitis) and Primary Sclerosing Cholangitis in Two Young Adult Females

Autoimmune Chronic Active Hepatitis (Lupoid Hepatitis) and Primary Sclerosing Cholangitis in Two Young Adult Females

Current and novel immunosuppressive therapy for autoimmune hepatitis

Management of patients with difficult autoimmune hepatitis

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